Primary MEMBER ID# *
Please use the Primary applicant Member ID#. Your Member ID# (MID#) is 9-digits, starts with a 1/2/3, and can be found on most correspondences from OW
Email *
If you do not have an email address please use the following format SAMSID@haltonfoodconnect.ca
Password *
Confirm Password *
First Name *
Last Name *
Phone Number *
Preferred Contact Method *
Type *
Address *
Apartment/Unit Number
City *
Province *
Postal Code *
Buzzer # or Entry Code

In order to qualify, you must be a resident of Halton Region, in receipt of Ontario Works, and not in receipt of a Rent-Geared-to-Income Housing Subsidy.

Are you a resident of Halton Region? *
Are you a recipient of assistance through Ontario Works? *
Dietary Considerations (Check all that apply) *
Other Dietary Considerations
POSSIBLE Delivery Day *
Choose a minimum of three dates
Preferred Delivery Windows *
Please check the days when you are available to receive a delivery. You will need to be physically present to receive your package.

Delivery times and days are not guaranteed but will be considered when planning deliveries.

Additional delivery information/instructions
Please let us know any other information or instructions regarding your delivery.
Protein Choice *
Would you like to add a produce bundle to your monthly protein delivery? *
Consent to receiving communications through the methods indicated above, note that costs may apply.

By submitting this form you are registering for the Halton Food Connect program and agree that you are aware of the Terms of Service and Privacy Policy. An intake specialist will review your registration and validate your account. Once your account is validated you will be granted access to the platform to choose your monthly box subscription.

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